Next Steps: Connecting to the Health Information Exchange

Transcription

1 Next Steps: Connecting to the Health Information Exchange Presented by Sean Kennedy, MS, PMP, MPH Director, Health Information EHR Next Chapter: Best Practices, Checklists, Guidelines Agenda Overview of the Mass HIway Review benefits of an HIE Describe a connection approach to the HIway The HIway compared to regional HIEs Review of challenges and solutions Questions and discussion 2 1

2 Mass HIway Launch October 16, 2012: Golden Spike Day! 4 2

3 Mass HIway Governance and Advisory Groups HIT Council Consumer Advisory Group Provider Advisory Group Technology Advisory Group Legal & Policy Advisory Group 5 Mass HIway Trust Community As a health information service provider (HISP), the Mass HIway is a trust community based on technical security standards and legal policies to which all participants agree. ASSURANCE Direct- compliant message transport Certificates & Addresses SECURITY Encryption Authentication TRUST PRIVACY Participation Packet Patient Consent 6 3

4 Mass HIway Roadmap PHASE 1 Direct Messaging Services PHASE 2 Query + Retrieve Services 2012 State assumes HISP role Directed exchange of electronic health information with gold-standard encryption Provider can push health information to another provider Includes identity & access management, message transformation, certificate repository, HIway directory 2014 Query-based exchange enabled (Master Person Index, Relationship Listing Service, Consent Database) DPH connection in support of MU2 7 Benefits of HIEs Improves & streamlines care coordination Improves patient safety - fewer medical errors Reduces duplication of tests Supports achieving Meaningful Use Eases & improves public health reporting & analytics Serves as a foundation for Accountable Care Organizations & value-based healthcare models 8 4

5 Health information exchange use in the ER lowers admissions by 30% J. R. Vest et al, Association between use of a health information exchange system and hospital admissions, Applied Clinical Informatics, Vol. 5: Issue , Mass HIway Get Connected 10 5

6 Mass HIway Develop a Use Case A few examples: Request a referral Receive a care summary Receive a discharge summary Receive lab results Get ED notifications Your use case should inform connection determination and help scope your effort 11 Mass HIway Determine Connection Type 12 6

7 Mass HIway Connection Options User Types Physician Practice Hospital Long-term Care Public Health Health Plans Labs /Pharmacy CONNECTION OPTIONS Webmail... LAND (Local Adaptor for Network Distribution).... Direct (EHR or local gateway)... HIway Services Secure Messaging HIway Directory Secure Web Mail Registry Interfaces Message Transformation Certificate Management Identify & Access Management 13 Mass HIway Connection Options 14 7

8 Mass HIway Get Connected 15 Mass HIway On-boarding = VERIFY, PROVISION, TEST 1. Participation Agreement 2. Services Addendum 3. Delegated Administration Agreement Scan and to: masshiway@state.ma.us 4. Access Administrator Designation Form 5. Access Administrator Agreement (x 2 copies for each) 6. W 9 form Important! Make sure your Agreement matches your W 9 Mail original signed copy to: Gina Ruvido Assistant to Manu Tandon EOHHS for the Commonwealth of Massachusetts 100 Hancock Street Cube 4035; 4 th floor Quincy, MA

9 Mass HIway Pricing Tier Category One-time Setup Fee LAND HIE Services (per node) Annual Services Fee Direct (XDR/SOAP or SMTP/SMIME) HIE Services (per node) Direct Webmail HIE Services (per user) Tier 1 Large hospitals $2,500 $27,500 $15,000 $240 Health Plans $2,500 $27,500 $15,000 $240 Multi-entity HIE $2,500 $27,500 $15,000 $240 Tier 2 Small hospitals $1,000 $15,000 $10,000 $240 Large ambulatory practices (50+) $1,000 $15,000 $10,000 $240 Large TLCs $1,000 $15,000 $10,000 $240 ASCs $1,000 $15,000 $10,000 $240 Non-profit affiliates $1,000 $15,000 $10,000 $240 Tier 3 Small LTC $500 $4,500 $2,500 $120 Large behavioral health $500 $4,500 $2,500 $120 Large home health $500 $4,500 $2,500 $120 Large FQHCs (10-49) $500 $4,500 $2,500 $120 Medium ambulatory practices (10-49) $500 $4,500 $2,500 $120 Tier 4 Small behavioral health $25 $250 $175 $60 Small home health $25 $250 $175 $60 Small FQHCs (3-9) $25 $250 $175 $60 Small ambulatory practices (3-9) $25 $250 $175 $60 Tier 5 Small ambulatory practices (1-2) $25 $60 $60 $60 17 * Rates for Direct Messaging Only. Get the full rate card by clicking here. 18 9

10 The HIway and Regional Exchanges The HIway is intended to be a network of networks is not a clinical repository rather it enables the secure transmission of clinical data is a HISP and employs Direct is priced to be the public option requires permission from the patient before sending their information over the HIway Regional HIEs are intended to provide added value to that region should be designed with the HIway in mind Both HIEs have the opportunity to leverage one another s strengths to fully connect and provide value to all providers in the State 19 Overcoming issues Aligning standards, technology, policy and priorities Constructing HIway on-ramps Catalyzing connections to the HIway Generating HIway stories 10

11 Aligning standards, technology, policy and priorities Constructing on-ramps HIway Interface Grants Alere Allscripts Azara Other vendors are also working to connect Cerner CPSI Epic MEDITECH OCHIN Secure Exchange Solutions (SES) SMART, Inc Surescripts 11

12 Catalyzing connections the HIway Implementation Grants 32 Grantees 75 Trading Partners Generating stories Reducing duplication of tests for high acuity cardiovascular patients Enhancing decision support through 2-way exchange of data Improving pre-hospital transport & care coordination for the homeless Coordinating care plans between a health plan and community health center Reducing readmissions and improve care management for heart failure patients Improving transitions of care from acute care to SNF and Home Health 12

13 What are grantees measuring? Our grantees and their collaborating organizations Hospital, Acute Care Group Practice Community Health Center Health System Behavioral Health Clinic Skilled Nursing Facility/Network HIT Vendor Home Care Agency Physician Network Visiting Nurse Network Accountable Care Organization Government Agency, State and Local Health Information Exchange Health Insurance Plan Independent Practice Association (IPA) Sole Proprieter Hospice Care Agency Hospital, Rehabilitation Laboratory Network Ambulance Service 13

14 How our grantees plan to use the HIway Receive Send Receive Care Receive Referral Receive Send Care Summary Send Referral Request Send Hospital Discharge Send Lab Results Send Hospital Discharge Receive Lab Results Receive Lab Orders Medication Reconciliation Send Lab and Radiology Send Imaging Notifications Receive Imaging Receive Hospital Receive ED Visit Send Hospital Admission Send Send ED Admission Send CANS Data to MDPH The HIway works and is delivery value! March Transaction Activity 133,937 Transactions exchanged during March 2,230,494 Total Transactions (inception to date) HIway Status (organizations) Count Contracted 140 Connected 105 SOURCE: Health Information Technology Council slides, April 7,

15 Key takeaways Start reviewing your PA early legal review takes time. Make it real. Identify a use case - plan the story! Engage your vendor early. Work with the HIway team to ensure they can connect to the HIway. Get started webmail is a great first step. Consent matters take time. Plan for it and engage other participants to learn from them. Using the HIway should not be viewed as just an IT project. Clinicians and business leaders need to be involved early - the impact on workflow cannot be underestimated. What s next Connected Communities Thank you! Sean kennedy@masstech.org 15